Provider Demographics
NPI:1083729602
Name:CODY, GEORGE M (LCSW-C)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:M
Last Name:CODY
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:DR
Other - First Name:GEORGE
Other - Middle Name:M
Other - Last Name:CODY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:10 S HANSON ST
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-3075
Mailing Address - Country:US
Mailing Address - Phone:032-913-1171
Mailing Address - Fax:
Practice Address - Street 1:10 S HANSON ST STE 30
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-3078
Practice Address - Country:US
Practice Address - Phone:203-913-1171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19604101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD19604OtherMARYLAND BOARD OF SOCIAL WORK EXAMINERS